Some type 2 diabetes medications may increase your risk of MS

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Certain diabetes medications can affect your risk of developing multiple sclerosis. Christina House/Los Angeles Times via Getty Images
  • The causes of many autoimmune conditions are unclear, and having one, like type 2 diabetes, could mean you’re more likely to develop another.
  • Multiple Sclerosis (MS) is a potentially debilitating condition, most cases of which are unexplained.
  • Recent research has proposed that people under the age of 45 with type 2 diabetes who are being treated with antihyperglycemic medications may be less likely to develop MS.
  • The same study found that those who start treatment with antihyperglycemic drugs over the age of 45 may have a higher risk of developing MS.

Multiple sclerosis (MS) is a potentially debilitating condition that affects the nerves’ ability to signal properly and is twice as common in women as men. Its possible causes are still unclear.

MS is considered an autoimmune disease and, like other autoimmune conditions, its causes are believed to be a combination of environmental and genetic factors.

MS occurs when the protective fatty sheath around nerve cells, known as myelin, degenerates, affecting cell signaling and causing symptoms such as vision problems, difficulty standing, bladder control and sexual problems. It can even cause partial paralysis.

Some people have type 2 diabetes (DM2) and multiple sclerosis. The researchers have observed that people with T2DM who receive antihyperglycemic drugs experience some improvement in their symptoms. Earlier this year, researchers launched a clinical trial to repurpose metformin, an antihyperglycemic drug, as an MS drug.

Recent research has looked at the effects of antihyperglycemic drugs used to treat T2DM on the risk of MS.

A retrospective study published in the journal little devil demonstrated that the use of antihyperglycemic drugs can help to reduce the risk of developing multiple sclerosis if the onset of DM2 and treatment occur before 45 years of age.

However, researchers have also found that these drugs can increase the risk of developing it in people over age 45, particularly in women.

In the current study, researchers at the University of Arizona, Tucson, examined a cohort of more than 5 million people with T2D from the Mariner Insurance Claims Database, and more than 1.5 million people were included in their final analysis.

The researchers then matched participants who had been exposed to antihyperglycemic drugs, including insulin, metformin, sulfonylureas, glitazones and DPP4 inhibitors to treat their T2DM, and those who had not.

Their findings showed that T2DM patients who took antihyperglycemic drugs had a 22% reduction in the risk of developing MS over a median follow-up of 6.2 years in patients younger than 45 years when they started taking them.

When individual drugs were analyzed, sulfonylureas alone or in combination with metformin were most significantly associated with a decrease in the risk of developing MS over the time period studied.

On the other hand, they also found that people who started treatment over the age of 45 had a 16% higher risk of developing MS.

Those who had the highest number of comorbidities had a 36% increased risk of developing MS if they took antihyperglycemic medications.

When the researchers looked at men and women separately, they found that women were at greater risk after using antihyperglycemics than men, for whom confidence in an association was low.

The researchers proposed that the difference could be due to menopause, which occurs in most women in their late 40s and early 50s, although perimenopause can start earlier.

They explain that T2DM control often worsens in women after menopause due to loss of estrogenic insulin control. This can lead to significant inflammation, they say, which can also lead to worsening MS symptoms.

However, they also note that the overall rate of MS is lower after age 40 and therefore at menopause, as previously found.

Having an autoimmune disease, where problems are caused by the immune system attacking cells it shouldn’t, is associated with an increased risk of other forms of autoimmune disease.

People with T2DM, for example, are at greater risk of developing multiple sclerosis, with women under 50 with T2DM being the highest risk, a cohort study in Taiwan showed. The authors suggested that the reasons were unclear, noting that while both are known to have some genetic factors, there are no common genetic risk factors between the condition.

Dr. Hana Patel, GP Chronic Illness and Mental Health Specialist and Mindset Coach said medical news today in an interview:

“It’s another risk factor associated with MS. But it’s not diabetes [that] cause, but since you’re more likely to have other autoimmune conditions, it’s more likely to happen to someone who has diabetes.

The findings are complicated by the fact that the diagnosis of multiple sclerosis can often be made years after the onset of symptoms, according to Dr. Achillefs Ntranos, Lead Neurologist and Multiple Sclerosis Specialist at Treat MS.

“The paper’s findings are intriguing but I wouldn’t say they are controversial as there may be a biological basis for them. Glucose metabolism is essential for the immune response, modulating it in a way that could have an effect in immune-mediated diseases such as multiple sclerosis,” he said. MNT🇧🇷

“However, this study has some limitations as it is a retrospective study based on an insurance claims database, which may harbor certain biases that could affect the results. Therefore, the results of this study need to be replicated in another cohort to strengthen their scientific validity,” he added.

Some type 2 diabetes medications may increase your risk of MS

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